Medical marijuana rules proposed

The draft regulations also include provisions to minimize the number of home cultivation sites.

Saying it hopes to create an “innovative and pragmatic system,” the state Department of Public Health released draft regulations for medical marijuana Friday.

Included in the draft regulations is defining a 60-day supply of medical marijuana as not more than 10 ounces, as well as the registration and certification process for medical marijuana treatment centers, patients and caregivers.

While the regulations state that patients, caregivers and treatment centers will be assessed a registration fee, the fees were not defined in draft regulations and have yet to be determined.

The draft regulations also include provisions to minimize the number of home cultivation sites by, among other things, allowing treatment centers to offer medical marijuana at reduced rates to low-income qualifying patients and for treatment centers to offer home delivery.

“DPH solicited an unprecedented level of input in drafting these regulations to create a medical marijuana system that is right for Massachusetts,” DPH Interim Commissioner Dr. Lauren Smith said.

“In this proposal, we have sought to achieve a balanced approach that will provide appropriate access for patients while maintaining a secure system that keeps our communities safe.

“We hope to build an innovative and pragmatic system that works best for Massachusetts,” Dr. Smith said.

The release of the draft regulations is the first major step in the process since the law was approved in the November election. Three public hearings are scheduled for April 19 in Northampton, Plymouth and Boston. Public comment will be accepted through April 20.

In creating the draft regulations, the DPH held a series of listening sessions across the state earlier this year for input and public comment, including one at the Worcester Public Library that was standing-room-only.

The DPH also reviewed the medical marijuana laws in 17 other states as well as collected input from legislators, patient advocates, prevention advocates, nationally recognized dispensaries, physicians, municipal leaders and law enforcement.

Dr. Smith said the DPH will be working this spring to determine a fee for patients, caregivers and treatment centers. She said the law requires the program to be “revenue neutral,” meaning it must be self-sustaining through the fees on medical marijuana treatment centers and on patients using these products.

Once the regulations are finalized, the application process for treatment centers will begin in late spring and last throughout the summer.

“Actually having a functioning and working medical marijuana treatment center is going to take several more months,” Dr. Smith said.

Other highlights of the draft regulations:

•A physician can issue a written certification beginning Jan. 1, 2014, to a patient with one of the qualifying medical conditions under the law, such as AIDS, cancer or ALS. The certification must be issued by a physician licensed in Massachusetts, a provision that was one way to ensure a patient and physician have a “bona fide relationship.” The certification will be valid for not more than one year and no less than two weeks. For patients under age 18, the patient must be diagnosed by two Massachusetts licensed physicians, at least one of whom is a board-certified pediatrician, with a debilitating, life-limiting illness and likely to die within six months.

•The DPH did not further define “debilitating conditions,” leaving that to the patient and doctor to determine. “The issue is how much impact a particular disease has on a patient, as well as highlighting the fact that this is a treatment understood to be used for people that have a significant illness that substantially affects their life and not to be used for a disease with minor symptoms,” Dr. Smith said.

•Patients certified to use medical marijuana must register with the DPH for a registration card. The card is valid for five years, and the patient information will be entered into a database, including the patient’s designated treatment center and the expiration date of their doctor’s certification. In addition, the designated treatment center can only be changed once in a 120-day period.

•Nonprofit medical marijuana treatment centers will operate their own cultivation and dispensing facilities to ensure uniform control and security. No wholesale distribution is allowed. Employees of the treatment centers must be at least 21 years old.

•The regulations limit the number of treatment centers owned by one nonprofit to no more than three in the state. Treatment centers must only cultivate their marijuana at either the dispensary or at an off-site location. The cultivation site can be used only for that dispensary or up to two other treatment centers that it is allowed to own.

•Home, or hardship cultivations, allow patients to grow marijuana for their medical needs in their home — or their caregiver’s home — because of a financial or physical hardship or a lack of a treatment center within a reasonable distance of the patient’s residence. The DPH aims to keep home cultivation sites to a minimum by allowing discounted rates for low-income residents at treatment centers; allowing secure home delivery where necessary; and encouraging personal caregivers to pick up the product at a treatment center.